Objectif - L'hydatidose hepatique, anthropozoonose due a un taenia du chien (Echinococcus granulosus), est rare en Europe occidentale, mais peut parfois etre diagnostiquee chez des immigres originaires du Bassin mediterraneen. Nous illustrons ici la clinique, le diagnostic et le traitement de cette pathologie a travers une etude retrospective. Materiel et methode - Nous avons etudie les dossiers de 97 patients consecutifs admis et operes durant l'annee 1998 pour maladie hydatique du foie dans un centre hospitalier universitaire de Tunisie centrale. Resultats - La moyenne d'age de nos patients etait de 41 +/- 19,8 ans (extremes quatre et 85 ans). Le motif de consultation le plus frequent etait la douleur (79,4 %), essentiellement au niveau de l'hypocondre droit. Cependant, la maladie a pu aussi etre decouverte fortuitement ou se manifester par des complications graves. La methode diagnostique qui s'est averee la plus sensible est l'echographie abdominale. Elle etait positive chez tous nos patients. Le traitement a ete chirurgical et partage entre deux types de methodes : les interventions radicales et conservatrices. Nous avons releve 16,5 % de complications postoperatoires (fistules et surinfections) pour les deux techniques. Conclusion - L'hydatidose hepatique est une maladie histologiquement benigne, mais potentiellement maligne par les complications qu'elle engendre. Bien qu'il existe des moyens therapeutiques efficaces, la prevention et l'education des populations des regions endemiques reste l'attitude a privilegier.
Objective - The hydatid cyst of the liver, an anthropozoonosis due to a cestode (Echinococcus granulosus), the usual host of which is the dog, is not common in Western Europe, but has been diagnosed in patients coming from Southern Europe and Northern Africa. This retrospective study describes the clinical, diagnostic, and therapeutic aspects of the hydatid echinococcosis. Material and methods - We examined the evolution of 97 consecutive patients admitted and treated surgically for a hydatid cyst in 1998 in a Central Tunisia university hospital. Results - The patients'mean age was 41 +/- 19.8 years (range: 4 and 85). The most common cause for consulting a physician was pain (79.4 %), usually located in the right upper quadrant. Sometimes, the disease occurred with the onset of serious complications. In some cases it was also discovered fortuitously. The most sensitive diagnostic method was abdominal echotomography, positive in every case. Serology and TD scan were also performed in some cases. The treatment was surgery with two methods: a radical and a conservative one; 16.5 % of postoperative complications are reported for both techniques (fistula and surinfection). Conclusion - The hydatid disease of the liver is a histologically benign pathology, but it may become dangerous because of possible serious complications. Although there are efficacious therapeutic weapons, prevention and education of the population living in endemic zones is strongly advised.